Provider Demographics
NPI:1568135846
Name:ORTALEZA, CHRISTOPHER I (DC)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:ORTALEZA
Suffix:I
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:442 3RD AVE APT 30
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6048
Mailing Address - Country:US
Mailing Address - Phone:585-729-0342
Mailing Address - Fax:
Practice Address - Street 1:442 3RD AVE APT 30
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6048
Practice Address - Country:US
Practice Address - Phone:585-729-0342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-31
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013557111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty